Einstein Changes the Equation

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In July, before the signage went up, a driver heading west on Germantown Pike might easily have mistaken the enormous construction site in East Norriton for a new regional arts center.

Set back from the road on an 84-acre former community golf course, with an impressive, sweeping glass atrium entrance, the building looks like anything but what it is: the first new hospital built in the Philadelphia area in 10 years. But Einstein Medical Center Montgomery is much more than its name implies. It’s a $400 million bet on the future for a hospital system that either had to grow dramatically and diversify its patient population or settle for being an underrated player in the crowded competitive regional health market.

“I guess it was six or seven years ago that our board made a very conscious decision to rebrand and reposition ourselves and come out from under the radar,” explains Barry Freedman, president and CEO of Einstein Health Network, as it’s now called. It was a bold step for a once prestigious hospital that had slipped in the arena of public opinion for reasons that had nothing to do with quality. It’s hard to get attention when 40 percent of the 600 beds in your flagship headquarters are filled with Medicaid patients and most of the rest with Medicare recipients. That’s the position Einstein had gotten itself into, and why it’s heavily investing in expansion to broaden its patient mix and bolster its bottom line.

It’s a tribute to Einstein that it has steadfastly refused to abandon its North Broad Street home, even when there weren’t enough private patients with good insurance to make it profitable. Richard Scheer, chairman of the board, says, “It was simply the right thing to do. The philosophy of tikkun olam tells us that, as Jews, we are obligated to try to make the world whole — not necessarily just for us, but for everyone. The commitment to those in need is a core value of Jewish life — and something we live by at Einstein.”

Like any other business, hospitals are subject to the real estate mantra: location, location, location. Maintaining core values wasn’t a problem for all the years that Einstein sat smack in the middle of a bustling, mostly white and Jewish neighborhood around Broad and Olney. But when the aftermath of World War II prompted the great migration to the suburbs, the geography that had been its great asset became a primary liability. What had been a thriving Jewish community slowly changed into a melting pot of minorities. Former patients didn’t want to drive back to the old, dilapidated neighborhood. They preferred the newer, fancier university hospitals. Still, Einstein decided to stay put and soldier on. “It was a moral issue,” CEO Freedman says. “Our mandate and our responsibility has always been to serve the under-served.”

That mission dates back to the Civil War, when Jewish-sponsored hospitals became part of the American medical landscape. What would develop into the Einstein Health Network was founded in 1866 as The Jewish Hospital, dedicated to serving Jewish patients, particularly Jewish Civil War veterans, as well as free colored people fleeing the South for a better life. By the 20th century, these Jewish-sponsored hospitals had also become havens for practicing Jewish doctors who couldn’t admit their patients to other institutions because of anti-Semitism.

In 1952, the three existing Jewish hospitals in Philadelphia decided to merge into one entity on North Broad Street. Seeking a more assimilated identity, someone came up with the name Albert Einstein Hospital. Who better symbolized their principles than a respected Jew at the nexus of humanity and science? A delegation drove to Princeton, where Einstein lived and taught, to ask the great man’s permission. His framed letter of consent hangs today in Barry Freedman’s office.

What has not been well-publicized is that through all the years of population change and geographic isolation, Einstein has never downgraded what it is and what it stands for: quality medical care. It has always been an independent academic institution (i.e. one without a medical school). Einstein Health Network annually recruits over 400 residents and fellows, making it one of the area’s largest and most active teaching hospitals. Medical students from Thomas Jefferson come here for some of their rotations. While not involved in laboratory research, it is deeply committed to clinical research and offers a menu of drug trials. Einstein is one of only 21 community hospitals in the nation to be designated a Community Cancer Program, part of the National Cancer Institute. When 17 area hospitals closed their maternity care departments, Einstein said, “We’ll make ours bigger and find a way to handle the losses.”

As a result, 3,000 babies a year take their first breath in an Einstein delivery room. The Women’s Health Center has the most current diagnostic equipment along with the services of outstanding doctors like Arnold Cohen, Debra Copit and Lisa Japlon, just three of the 31 Einstein staff named “Top Docs” by Philadelphia magazine in 2012. There is an excellent bariatric surgery department, transplant and cardiac surgery units, all of which, taken together, have garnered a slew of recognition awards from organizations that rate the quality and delivery of health care nationwide.

The growing Einstein family includes Elkins Park Hospital, Belmont Behavioral Health — a highly respected, 194-bed, in-patient treatment facility for troubled adults and adolescents, and the jewel in its crown: Moss Rehabilitation Hospital, which was ranked first in Pennsylvania and among the top 10 in the country for rehab medicine. If it’s broke, Moss can fix it. Now that Einstein has been stricken with expansion fever, it will also be adding specialty out-patient sites, like the one planned for later this year across from the Plymouth Meeting Mall. “Our goal,” says board chair Scheer, “is to become the pre-eminent deliverer of sophisticated, high-quality health care to the under-served region of Northeast Philadelphia and Montgomery County.” And that is what led Einstein to start digging up the ground off Germantown Pike.

In 2011, after Einstein purchased the 177-bed, Norristown-based Montgomery Community Hospital (which will close in September), a survey of surrounding area ZIP codes revealed that 65 percent of local residents drove more than a half-hour to get to a hospital. Here was just the suburban population Einstein needed, along with the void and the opportunity they were seeking. As luck would have it, there just happened to be a significant Jewish population, too.

The new, light-flooded five-story Einstein Medical Center Montgomery is a 146-bed hospital with the built-in capability to add 60 more beds in the future. All the rooms are private, and half of them face a bucolic nature preserve of wide lawns and old trees, giving patients the calming sense of resting in a country inn. Every room has its own thermostat, a 42-inch entertainment center with Internet access, blackout window shades and a sleep couch for family members who stay overnight. The amenities do more than pay lip service to patient needs. For example: There are no fixed visiting hours. Meals are served from 6 a.m. to 9 p.m. on request — no trays automatically show up for lunch at 11:30 when you are still full from breakfast. Every room in the intensive care unit, which is conveniently located next to the operating room suite, has a private bath. Every 110-square-foot room in the emergency room has real walls, not curtain partitions. The six labor and delivery rooms are midwife-friendly and spacious enough for dad, the other kids and the rest of the family to be part of the birth and the Level 3 neonatal intensive care unit has eight rooms with rockers and sofa beds so mothers can stay with babies who have to remain in the hospital. Patient elevators are separate from visitor elevators to maintain privacy.

On the medical side, everything was designed for efficiency and convenience. The NICU has rubberized floors to reduce noise that might disturb sleeping infants; all the operating rooms are housed in one section and specially equipped: one for robotic surgery, one for cardio-thoracic, four for general purpose, plus two labs for cardio-catheterization and one each for electro-physiology and interventional radiology. The ER is immense, with 42 treatment bays, eight dedicated beds for patients who need to be monitored for up to 23 hours, and a fast-track system to prioritize the guy having a heart attack ahead of the lady with a sore throat. In short, this is a place that does everything to make a hospital stay like a hotel visit with medical perks.

If it delivers on its expectations — and it’s hard to see how it could fail — Montgomery will raise Einstein to another level, revitalize its reputation and make it competitive with area systems like Main Line Health. “If you’re not growing, you’re contracting,” Barry Freedman says. “And growing is necessary to life.”

Carol Saline is the chief medical correspondent for Inside and Special Sections.